Stress deprivation alters the morphologic, biochemical, and biomechanical characteristics of various components synovial joints. Prominent among protean changes that result are proliferation fibrofatty connective tissue within joint space, adhesions between folds, adherence to cartilage surfaces, atrophy cartilage, "ulceration" at points cartilage-cartilage contact, disorganization cellular fibrillar ligament alignment, weakening insertion sites owing osteoclastic resorption bone Sharpey's...

This prospective longitudinal multicenter study of ambulatory children with cerebral palsy (CP) examined changes in outcome tool score over time, responsiveness, and used a systematic method for defining minimum clinically important differences (MCIDs). Three hundred eighty‐one participants CP (Gross Motor Function Classification System [GMFCS] Levels I–III; age range 4–18y, mean 11y [SD 4y 4mo]; 265 diplegia, 116 hemiplegia; 230 males, 151 females). At baseline follow‐up at least 1 year...

A longitudinal study over a mean of 32 months was conducted on 18 subjects with spastic diplegia, ranging in age from 4 to 14 years. Three-dimensional gait analyses were performed compare the temporal and kinematic data across two time intervals. The comparison revealed deterioration stability evidenced by increases double support decreases single growth (p < 0.05). Kinematic analysis loss excursion about knee, ankle, pelvis Additionally, passive range-of-motion decrease popliteal angle In...

Summary: Two groups of patients with cerebral palsy (CP) were studied pre- and postoperatively by gait analysis after proximal release or distal transfer the rectus femoris for treatment knee stiffness in swing phase. In first group studied, 12 underwent muscle release. second group, 10 transfer. After surgery, peak flexion was increased 9.1° phase 16.2° Hip motion throughout cycle not significantly affected either operation, no tendency a crouch observed procedure.

Two groups of patients with cerebral palsy (CP) were studied pre- and postoperatively by gait analysis after proximal release or distal transfer the rectus femoris for treatment knee stiffness in swing phase. In first group studied, 12 underwent muscle release. second group, 10 transfer. After surgery, peak flexion was increased 9.1 degrees phase 16.2 Hip motion throughout cycle not significantly affected either operation, no tendency a crouch observed procedure.

This study aimed to explore the limitations of Ashworth scale for measuring spasticity. An isokinetic dynamometer quantify resistance passive stretch and surface EMG was used verify if a response occurred and, so, at what joint angle. The authors sought determine which components (magnitude, rate change, onset angle stretch, or velocity dependence) were most related scores motor function in cerebral palsy (CP). Twenty-two individuals with spastic CP (11 males, 11 females; mean age 11.9...

It should be recognized that these guidelines not deemed inclusive of all proper methods care or exclusive reasonably directed to obtaining the same results. The ultimate judgment regarding propriety any specific procedure must made by physician in light circumstances presented individual patient.

The purpose of this study was to investigate the use perichondrial grafts in articular cartilage defects and characterize newly formed cartilage. In a rabbit model, rib perichondrium used repair full-thickness femoral condyle. quality then evaluated histologically biochemically at six twelve weeks after grafting. Unacceptable results were obtained 50 per cent rabbits. These failures due condylar fracture 20 cent, failure graft attachment infection 10 cent. technique grafting must be improved...

Based on the best current evidence and a systematic review of published studies, 14 recommendations have been created to guide clinical practice management supracondylar fractures humerus in children. Two each these are graded Weak Consensus; eight Inconclusive. The two Moderate include nonsurgical immobilization for acute or nondisplaced posterior fat pad sign, closed reduction with pin fixation displaced type II III flexion fractures.

Cerebral palsy (CP) is associated with reduced muscle volumes, but previous studies have reported deficits in only a small number of muscles. The extent volume across lower limb muscles not known. This study presents an imaging-based assessment and length 35 muscles.We imaged segmented 10 subjects CP 8 typically developing (TD) controls using MRI. Muscle volumes were normalized, Z-scores computed TD data. Volume percent volume, length, cross-sectional area are reported.Muscle 20% lower, on...

Despite the lack of consensus role spasticity in observed motor disability cerebral palsy (CP), alleviation remains a primary focus clinical management these patients. The purposes this study were to: (1) quantify voluntary torque and passive resistance across speeds hamstrings quadriceps muscle groups with respect to presence stretch responses and/or stiffness patients CP compared age‐related children without disability, (2) relate parameters each other functional performance, as measured...

SUMMARY The Gross Motor Function Measure (GMFM) and computerized gait analysis are commonly used to assess patients with cerebral palsy (CP). authors investigated correlations between the GMFM parameters in 32 children aged 3 18 (mean 8.9) years spastic CP. Of parameters, cadence normalized velocity correlated most strongly score, hip knee excursion percentage single support also directly GMFM. In a stepwise multiple regression, alone was significant predictor of score. Time distance...

Summary: A longitudinal study over a mean of 32 months was conducted on 18 subjects with spastic diplegia, ranging in age from 4 to 14 years. Three-dimensional gait analyses were performed compare the temporal and kinematic data across two time intervals. The comparison revealed deterioration stability evidenced by increases double support decreases single growth (p < 0.05). Kinematic analysis loss excursion about knee, ankle, pelvis Additionally, passive range-of-motion decrease popliteal...

The study was designed to determine the strategies used by diplegic subjects change walking speed. Two groups, limited community ambulators and ambulators, were compared with controls if ability increase speed would decrease as a function of motor impairment. Compared matched controls, slower relied more on cadence velocity stride length significantly less in groups than accounted for wider difference their fast velocity. Velocity decreased, whereas stance time increased involvement. In...

Hip measurements using three-dimensional (3-D) images and computed tomography (CT) scans were evaluated. The 3-D proved more accurate than CT of femoral acetabular anteversion. Additionally, (> 99%) the neck-shaft angle provided. Acetabular anteversion determinations by systematically decreased as pelvic flexion increased, whereas accuracy was > 96% with images. software allows image rotation in all three reference planes, which minimizes positional errors. A case study is provided to...

Infection is a serious complication of surgery to correct scoliosis in patients with cerebral palsy (CP). We obtained multicenter representative figures for deep and superficial infection rates, analyzed risk factors treatment outcomes, compared deformity correction relative infection. retrospectively reviewed 157 who had posterior spinal fusion CP at one eight centers. Preoperative intraoperative variables were subjected multivariate analysis determine predictive There 16 wound infections...

In Brief Study Design. Therapeutic comparative study. Objective. To evaluate the safety and efficacy of antifibrinolytic (AF) agents in reducing blood loss transfusions during posterior spinal fusion (PSF) children with cerebral palsy (CP) scoliosis. Summary Background Data. Scoliosis surgery CP is associated substantial loss. Few reports on role AFs exist. Methods. A multicenter, retrospective review a prospectively collected database 84 consecutively enrolled patients CF (age < 18 years)...

The Gross Motor Function Classification System (GMFCS) of cerebral palsy categorizes patients by mobility. Patients at GMFCS level 5 are considered the most disabled and high risk hip spine problems, yet they represent a wide spectrum function. Our aim was to subclassify who underwent spinal arthrodesis on basis central neuromotor impairments assess whether subclassification predicted postoperative complications changes in health-related quality life.Using prospective registry, we identified...